Modified ride-on toy cars for early power mobility: a technical report.
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ABSTRACT: Background and purpose
Children with significantly decreased mobility have limited opportunities to explore their physical and social environment. A variety of assistive technologies are available to increase mobility; however, no single device provides the level of functional mobility that children developing typically enjoy. The purpose of this technical report is to formally introduce a new power mobility option--the modified ride-on toy car.Key points
This report will provide (a) an overview of toy car features, (b) examples of basic electrical and mechanical modifications, and (c) a brief clinical case.Clinical implications
With creative use and customized modifications, toy cars can function as a "general learning environment" for use in the clinic, home, and school. As such, we anticipate that these cars will become a multiuse clinical tool to address not only mobility goals but also goals involving body function and structure such as posture and movement impairments.
SUBMITTER: Huang HH
PROVIDER: S-EPMC3324847 | biostudies-literature | 2012
REPOSITORIES: biostudies-literature
Publications
Modified ride-on toy cars for early power mobility: a technical report.
Huang Hsiang-Han HH Galloway James C JC
Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association 20120101 2
<h4>Background and purpose</h4>Children with significantly decreased mobility have limited opportunities to explore their physical and social environment. A variety of assistive technologies are available to increase mobility; however, no single device provides the level of functional mobility that children developing typically enjoy. The purpose of this technical report is to formally introduce a new power mobility option--the modified ride-on toy car.<h4>Key points</h4>This report will provide ...[more]
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Project description:BackgroundResearch has shown that the use of power mobility devices is safe and beneficial for motor and cognitive development in children with motor disabilities; nevertheless, strong evidence of the benefits for social skill development is limited. This study aimed to examine the effects of combining ride-on car training with an adult-directed, social interaction program in a hospital-based environment on mobility and social functions in young children with motor disabilities.MethodsThis study used a prospective, nonequivalent pretest-posttest control group design. Twenty-nine young children with motor disabilities, aged between 1 and 3 years, were recruited from local hospitals in Taiwan. The treatment group (n = 15) underwent 2-h ride-on car training sessions twice per week for a total of 9 weeks in the hospital environment. The control group (n = 14) underwent a 9-week home education program (mean: 200 min/week) focusing on mobility and social skills training. The Chinese version of the Pediatric Evaluation of Disability Inventory, Parenting Stress Index, and Goal Attainment Scaling were administered to all participants before and after the intervention, and at the end of the 9-week follow-up phase.ResultsMobility and social functions significantly improved in both groups after the 9-week intervention, but this improvement was not maintained at the follow-up phase. The treatment group showed significantly better improvement in social function, parenting stress levels, and goal achievement than the control group at posttest.ConclusionThis two-group design study showed the benefits of combining a ride-on car use with a family-centered, structured, social interaction program for positive impacts on mobility, social function, and parenting stress levels. The combination of a modified ride-on car and a social training program has the potential to enhance socialization in young children with motor disabilities.Clinical trial registrationwww.ClinicalTrials.gov, identifier NCT02527499.
| S-EPMC5776004 | biostudies-literature
Project description:BackgroundModified ride-on cars (MROC) are a low-cost option to provide self-directed mobility to children with mobility limitations, in lieu of or as a precursor to other powered mobility devices.ObjectivesWe appraised evidence to (1) describe and categorize MROC study characteristics, (2) synthesize existing knowledge of children's use of MROCs and (3) frame outcomes within the International Classification of Functioning, Disability and Health (ICF) framework.MethodsArticles were identified through four electronic databases: Medline, CINAHL, PsycNET, and Web of Science. We included all published, peer-reviewed studies involving MROC use. Relevant data were extracted, and articles were appraised using the American Academy of Cerebral Palsy and Developmental Medicine criteria for group and single-subject designs.Results23 studies met inclusion criteria of 204 titles identified from 1980 to 2021. Study designs included case studies, case series, group designs, and qualitative research, but only three studies were rated evidence level III or higher. Children with a range of disabilities used MROCs across multiple settings, including the home, hospital, and community, though use and adherence varied widely. Positive impacts were reported on a range of outcomes related to the ICF framework, with an emphasis on activity and participation.ConclusionsMROC studies have primarily addressed activity and participation, with most studies suggesting increased functional mobility and social interactions due to MROC use. More robust research designs with larger samples are needed in order to develop evidence-based strategies for MROC use.IMPLICATIONS FOR REHABILITATIONPhysical and occupational therapists may consider using MROCs as a therapeutic tool or accessible play opportunity as part of a multi-modal approach to increase children's mobility, family engagement, and participation in community life.Personal (e.g., child's enjoyment) and environmental factors (e.g., caregiver attitudes and stress) must be considered when developing plans of MROC use.
| S-EPMC9328769 | biostudies-literature
Project description:Introduction and importance Pancreatic body and tail adenocarcinoma is a tumor of silent evolution, showing up as advanced disease at diagnosis in the majority cases. Case presentation A 60-year-old man, presenting a solid expansive lesion (3.1 × 2.8 cm) in the body of the pancreas, by imaging exams. There was 50% involvement of the celiac trunk at the level of the it's bifurcation and suspected peripancreatic lymph nodes. Clinical staging was cT4N1M0. After neoadjuvant chemotherapy (NQT), there was a small reduction of the tumor to 3.0 × 2.6 cm, an important decreasing of the celiac trunk involvement (25%), and also a reduction in the levels of C19–9 from 650 U/mL to 358 U/mL. Further on, the patient underwent a Robotic Modified Appleby procedure, without intra and postoperative complications. Clinical discussion Locally advanced pancreatic tumors should be referred to NQT, and those with good response might benefit to radical surgery. The modified Appleby technique - distal pancreatectomy with splenectomy and celiac trunk resection – is the procedure of choice when there is involvement of celiac trunk, but concern must be given to the liver vascularization. The use of robotic system on pancreatic surgery is emerging, but still, there is lower data regarding its safety in major pancreatic procedures. Conclusion The use of neoadjuvant therapy is recommended to assess the in vivo response, improve oncological results and increase negative margins. Pre-operative imaging is mandatory for surgical planning. The robotic modified Appleby procedure is feasible and safe, with reduced of intraoperative blood loss and transfusion rate, corroborating the literature. Highlights • 30% of pancreatic cancer presents as locally advanced disease at diagnosis with invasion to vascular structures.• Arterial involvement is the biggest challenge for oncological resection, and involvement of the celiac axis or its branches can make curative resection impossible• Robotic systems have been used in pancreatic surgery, but there is fewer data regarding feasibility and safety in major procedures.• Preoperative radiology is crucial to assess the response to neoadjuvant therapy and allows for the analysis of vascular anatomy.
| S-EPMC9189992 | biostudies-literature
Project description:BackgroundOne of the main difficulties in a transforaminal endoscopic lumbar discectomy (TELD), and simultaneously the most critical step, is performing an effective and safe foraminoplasty, which is especially difficult for beginners. To make it safer and faster for beginners to perform, we have used a specially designed power-aided reciprocating burr for TELD and reported the technical details.MethodsFrom Jan. 2019 to Nov. 2022, 432 patients with single-level, symptomatic L4/5 or L5/S1 disc herniation were treated with TELD using a novel power-aided reciprocating burr. The surgical procedure is described in detail. Magnetic resonance imaging (MRI) was performed the following day and 3 months after the operation. The learning curves of surgeons with different seniority levels are displayed. The Visual Analogue Scale (VAS) score and the Oswestry Disability Index (ODI) were used to measure low back pain, leg pain, and lumbar function. All patients were followed up for at least 1 year.ResultsAll patients underwent endoscopic surgery successfully. Among the 432 patients, radicular outer membrane damage was observed in 6 cases, and 1 case had hernia of the nerve tract. Except for this patient with aggravation of postoperative numbness, the postoperative neurological symptoms of all patients were significantly improved. The mean VAS scores for low back pain and leg pain and ODI scores were significantly decreased 6 w post-operatively and were maintained until 12 months post-operatively compared to preoperative scores (P < 0.05). All three doctors involved in the study had substantial experience in traditional open spinal surgery. The more operations all three surgeons completed, the more time spent on intervertebral foraminoplasty decreased (P < 0.05). Among them, doctors without experience in TELD surgery became proficient in this technique after accumulating experience in 13 cases. There was no significant difference in foraminoplasty time among these three surgeons during the same growing period (P > 0.05).ConclusionsCurrent clinical data demonstrated the safety and efficacy of modified TELD using a power-aided reciprocating burr for treating lumbar disc herniation (LDH) and showed that this technique significantly reduces the learning curve for beginners when performing foraminoplasty.
| S-EPMC9849748 | biostudies-literature
Project description:Interest and investment in electric vertical takeoff and landing aircraft (VTOLs), commonly known as flying cars, have grown significantly. However, their sustainability implications are unclear. We report a physics-based analysis of primary energy and greenhouse gas (GHG) emissions of VTOLs vs. ground-based cars. Tilt-rotor/duct/wing VTOLs are efficient when cruising but consume substantial energy for takeoff and climb; hence, their burdens depend critically on trip distance. For our base case, traveling 100 km (point-to-point) with one pilot in a VTOL results in well-to-wing/wheel GHG emissions that are 35% lower but 28% higher than a one-occupant internal combustion engine vehicle (ICEV) and battery electric vehicle (BEV), respectively. Comparing fully loaded VTOLs (three passengers) with ground-based cars with an average occupancy of 1.54, VTOL GHG emissions per passenger-kilometer are 52% lower than ICEVs and 6% lower than BEVs. VTOLs offer fast, predictable transportation and could have a niche role in sustainable mobility.
| S-EPMC6456499 | biostudies-literature
Project description:ObjectivesDescribe and compare young children's use of four early power mobility devices and examine associations between child and environmental factors that may influence power mobility use and parent device preference.DesignCross-sectional observational study.MethodsPower Mobility Days introduced four devices: Wizzybug, Bugzi, Tiger Cub, and a switch-adapted ride-on toy car in a single 60-90 min, play-based session.ResultsA convenience sample of 74 children, aged 9-68 months (mean: 32.45, SD: 14.08) with mobility limitations, and their parents participated. Children had a range of motor, postural and communication profiles, with cerebral palsy being the most common condition (n = 55; 73.33%). Assessment of Learning Powered mobility use phase achieved ranged from 1 to 6; mean: 2.34; median: 2. For children who tried all four devices (n = 51), Friedman test (χ2: 8.27, p = 0.04) suggests Assessment of Learning Powered mobility use phase differs across devices. Of 73 parents who identified a device preference, 43 (59%) chose Wizzybug. Regression analyses suggest that access method and communication function may influence children's power mobility use, while age, access and postural support requirements may influence parent device choice.DiscussionParent impressions of an early power mobility device may be influenced by many factors, yet be less influenced by child performance.
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Project description:When traveling in cars, we can unintentionally carry and disperse weed seed; but which species, and where are they a problem? To answer these questions, we systematically searched the scientific literature to identify all original research studies that assess seed transported by cars and listed the species with seed on/in cars. From the 13 studies that fit these criteria, we found 626 species from 75 families that have seed that can be dispersed by cars. Of these, 599 are listed as weeds in some part of the world, with 439 listed as invasive or naturalized alien species in one or more European countries, 248 are invasive/noxious weeds in North America, 370 are naturalized alien species in Australia, 167 are alien species in India, 77 are invasive species in China and 23 are declared weeds/invaders in South Africa. One hundred and one are classified as internationally important environmental weeds. Although most (487) were only recorded once, some species such as Chenopodium album, Poa pratensis and Trifolium repens were common among studies. Perennial graminoids seem to be favoured over annual graminoids while annual forbs are favoured over perennial forbs. Species characteristics including seed size and morphology and where the plants grew affected the probability that their seed was transported by cars. Seeds can be found in many different places on cars including under the chassis, front and rear bumpers, wheel wells and rims, front and back mudguards, wheel arches, tyres and on interior floor mats. With increasing numbers of cars and expanding road networks in many regions, these results highlight the importance of cars as a dispersal mechanism, and how it may favour invasions by some species over others. Strategies to reduce the risk of seed dispersal by cars include reducing seed on cars by mowing road verges and cleaning cars.
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Project description:ObjectiveTo introduce a technique of laminotomy using a common trephine to enlarge the interlaminar space at L4/5 segment for interlaminar endoscopic lumbar discectomy (IELD) and report the anatomical basis of this procedure, technical details, as well as primary clinical outcomes of a consecutive patient cohort with L4/5 lumbar disc herniation (LDH).MethodsOn anteroposterior fluoroscopy, the intersection of the medial edge of the inferior articular process and the inferior endplate of L4 vertebra was taken as the target. Using a common trephine, laminotomy was performed to remove a big portion of the posterior wall of the canal under the guidance of endoscopy. From June 2018 to December 2021, the consecutive patients who underwent L4/5 IELD were prospectively studied. Clinical outcomes were assessed at the day before surgery, 1 day, 1 month, 3 months, 12 months after surgery, and the last follow-up. Numerical Rating Scale, Roland-Morris Disability Questionnaire (RMDQ), and MacNab criteria were used to evaluate back and leg pain, the quality of life, and clinical efficacy, respectively.ResultsThere were 64 men and 44 women, with an age of 50.3 ± 14.9 years. The operating time was 74.54 ± 17.42 minutes. The mean follow-up time was 32.7 ± 18.6 months (range, 12-64 months). The complications of IELD included numbness, neck pain, and recurrence. Both leg pain (6.2 ± 1.9 vs. 1.8 ± 0.8, p < 0.001) and back pain (3.1 ± 2.3 vs. 1.7 ± 0.9, p < 0.001) quickly improved after this procedure and maintained (1.1 ± 1.5, 1.1 ± 1.3) at final follow-up. Physical disability due to back pain, as assessed using RMDQ, was improved remarkably after surgery (15.0 ± 5.8 vs. 2.9 ± 4.1, p < 0.001). In addition, MacNab outcome grade was evaluated as good-to-excellent in 96 cases (88.9%).ConclusionA convenient technique of laminotomy using a common trephine was proposed for the L4/5 IELD. It can efficiently enlarge the interlaminar entry to perform endoscopic discectomy. This procedure is particularly suitable for treating LDH with concomitant lumbar spinal stenosis and migrated herniated disc.
| S-EPMC10762391 | biostudies-literature
Project description:BackgroundThe health benefits of bicycling in older adults with mobility limitation (ML) are unclear. We investigated ML and functional capacity of older cyclists by evaluating their instrumental activities of daily living (IADL), intellectual activity, and social function.MethodsOn the basis of interviews, 614 community-dwelling older adults (after excluding 63 participants who never cycled) were classified as cyclists with ML, cyclists without ML, non-cyclists with ML (who ceased bicycling due to physical difficulties), or non-cyclists without ML (who ceased bicycling for other reasons). A cyclist was defined as a person who cycled at least a few times per month, and ML was defined as difficulty walking 1 km or climbing stairs without using a handrail. Functional capacity and physical ability were evaluated by standardized tests.ResultsRegular cycling was documented in 399 participants, and 74 of them (18.5%) had ML; among non-cyclists, 49 had ML, and 166 did not. Logistic regression analysis for evaluating the relationship between bicycling and functional capacity revealed that non-cyclists with ML were more likely to have reduced IADL and social function compared to cyclists with ML. However, logistic regression analysis also revealed that the risk of bicycle-related falls was significantly associated with ML among older cyclists.ConclusionsThe ability and opportunity to bicycle may prevent reduced IADL and social function in older adults with ML, although older adults with ML have a higher risk of falls during bicycling. It is important to develop a safe environment for bicycling for older adults.
| S-EPMC4884899 | biostudies-literature
Project description:Recently, motorized mobility devices (or power mobility devices (PMDs)) have been introduced for infants and toddlers who lack the means for self-mobility. Previous reports have primarily focused on PMDs for individuals with cerebral palsy. Few have explored PMDs for individuals with neuromuscular diseases who have intellectual disabilities. This report presents a case study of the early introduction of a PMD for an infant with Fukuyama congenital muscular dystrophy and presents the results of an interview with the father regarding psychological aspects and the child's manipulative abilities. The PMD was introduced at the age of 1 year and 10 months, and the changes during the 19 months after the introduction were evaluated six times, using the Assessment of Learning Powered mobility use tool (ALP). A semi-structured interview with the father was conducted 19 months after the introduction. The ALP evaluation and the interview were conducted by one physical therapist and two physical therapy students, and the results were shared with the hospital's physical therapist and nurses at the nursing facility. This report provides a basis for expanding the scope of PMD use and for considering the family's involvement, especially for the child.
| S-EPMC10366897 | biostudies-literature